33D2192815 CLIA NUMBER - CITY MEDICAL OF UPPER EAST SIDE PLLC

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Laboratory Demographics

CLIA Number: 33D2192815

Facility Name: CITY MEDICAL OF UPPER EAST SIDE PLLC

Facility Address:
48 E 170TH ST
BRONX, NY
ZIP 10452
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Facility Phone Number: 646 346-7920

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477197796

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	33D2192815
LAB Type	Physician Office
Facility Name	CITY MEDICAL OF UPPER EAST SIDE PLLC
Street	48 E 170TH ST
City	BRONX
State	NY
ZIP	10452
Phone	646 346-7920
CertificateType	4
CertificateEffectiveDate	9/15/2020
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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This page was last updated on: 4/23/2024